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Vitamin D Deficiency, Screening, 2015

* Indicates an old grade definition

Recommendations: Screening for Vitamin D Deficiency

  • Vitamin D Deficiency: Screening -- Community-dwelling, Nonpregnant, Asymptomatic Adults
    Grade: I
    Specific Recommendations:

    The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for vitamin D deficiency in asymptomatic adults.

    Frequency of Service:

    No Frequency of Service information currently available.

    Risk Factor Information:

    Although there is not enough evidence to support screening for vitamin D deficiency, some evidence suggests factors that may increase risk for vitamin D deficiency. Persons with low vitamin D intake, decreased vitamin D absorption, and little or no sun exposure (for example, due to the winter season, high latitude, or physical sun avoidance) may be at increased risk for vitamin D deficiency. Obesity and darker skin pigmentation may also be associated with low levels of total serum 25-(OH)D, but whether these factors reflect vitamin D deficiency or increase the risk for adverse clinical outcomes is unclear. Obesity may allow for greater sequestration of vitamin D into adipose tissue; however, this vitamin D may still be bioavailable. Increased skin pigmentation reduces the skin's ability to produce vitamin D in response to UVB exposure. Prevalence rates of low total serum 25-(OH)D are 2 to 9 times higher in African Americans and 2 to 3 times higher in Hispanics than in white persons, yet the risk for fractures in African Americans is half that in white persons. Other factors, such as body composition and calcium economy, have been proposed to explain this paradox; however, a recent study suggests that although total serum 25-(OH)D levels in African Americans may be low, the concentration of bioavailable 25-(OH)D may not be. Some evidence suggests that older age and female sex may also be associated with increased risk for vitamin D deficiency; however, these findings are inconsistent.

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